Serum Periostin Level in Children with Asthma

Objectives To determine the average serum periostin level in children with asthma between 6 and 16 y of age, and to fnd out if the levels correlated with markers of eosinophilic infammation, asthma control, and severity. Methods Children under follow-up at a tertiary care centre were enrolled. Children with conditions causing elevated serum periostin other than asthma, or history of systemic steroid use in the past 6 mo were excluded. Serum total IgE and periostin were estimated by ELISA. Results The median (IQR) serum periostin level was 52.6 (45.4, 58.3) ng/mL. Levels did not vary with age, gender, duration of symptoms, positive family history, or history of exacerbations in the last 6 mo. There was no signifcant correlation with anthropometric parameters or their z scores, or markers of eosinophilic infammation in blood including serum total IgE, eosinophil percentage or absolute eosinophil count. There was no diference in median periostin levels of children with diferent asthma symptom control or asthma severity. Conclusions In a group of 26 Indian children with physician-diagnosed asthma, serum periostin showed no signifcant correlation to markers of eosinophilic infammation.

Effects of single nucleotide polymorphism of drug metabolizing enzyme cytochrome P450 on the efficacy of inhaled cortisol hormone in asthmatic children / 中国临床药理学与治疗学

AIM: To elucidate the relationship between childhood asthma susceptibility and clinical efficacy of inhaled glucocorticoids (ICS) in children with different genotypes of asthma by exploring rs776746 and rs15524 single nucleotide polymorphisms (SNPs) of cytochrome P450 enzyme 3A5 (CYP3A5) gene in asthmatic children and healthy children. METHODS: The CYP3A5 gene rs776746 and rs15524 polymorphic sites were detected in 79 children (Case group) with asthma of Han nationality and 100 healthy children (Control group) who met the inclusion criteria admitted to the Northern Theater General Hospital in Northeast China from October 2016 to October 2020, and genotype, allele and linkage analysis were performed. The case group was given inhaled glucocorticoids by nebulised inhalation for 3 months, and lung function and exhaled breath nitric oxide (FeNO) were measured at entry and after treatment, and asthma control score C-ACT/ACT was done after treatment, so as to compare the prevalence of different genotypes and the differences in the above test index scores. RESULTS: There was complete linkage disequilibrium at rs776746 and rs15524 loci. There were three genotypes of T/T, T/C and C/C at rs776746 locus of CYP3A5 gene. There were significant differences in the frequency of different genotypes between the case group and the control group (χ

Clinical Randomized Controlled Observation of Modified Wuhutang in Treatment of Acute Asthma in Children / 中国实验方剂学杂志

ObjectiveTo explore the clinical effect of modified Wuhutang in the treatment of children with acute asthma. MethodA total of 130 children with acute asthma were randomly divided into an observation group and a control group， with 65 cases in each group. The observation group was treated with modified Wuhutang and the control group was treated with procaterol hydrochloride for one week. The scores of primary symptoms （wheezing， cough， shortness of breath， and chest tightness） and secondary symptoms （mental status， runny nose， dry mouth， tongue texture， tongue coating， stool， etc.）， lung functions， immunoglobulin E （IgE） expression， eosinophil （EOS） count， and serum inflammatory factors， including interleukin （IL）-5， IL-6， IL-8， and IL-1β in two groups before and after treatment were compared. ResultThe data of 126 children were statistically analyzed. As revealed by the results， compared with the conditions before treatment， the scores of primary symptoms and secondary symptoms， serum levels of IL， IgE expression， and EOS count were both reduced in two groups （P<0.05）， lung functions were increased in the two groups（P<0.05）. Compared with the control group after treatment， the observation group showed decreased scores of cough and secondary symptoms （P<0.05）， and insignificant decrease in IL-1β （P<0.05）. The improvement in lung functions， IgE expression， and EOS count in observation group was equivalent to that in control group. ConclusionModified Wuhutang for treatment of acute asthma in children （phlegm-heat obstructing lung syndrome） can significantly relieve the clinical symptoms， improve lung functions， and reduce IgE， IL-5， IL-6， IL-8， IL-1β expression levels and EOS count， and its overall clinical efficacy is superior or equivalent to that of tprocaterol hydrochloride.

Application of fractional exhaled nitric oxide and nasal nitric oxide in control evaluation of bronchial asthma and diagnosis of allergic rhinitis in children / 中国当代儿科杂志

OBJECTIVES@#To study the association of fractional exhaled nitric oxide (FeNO) and nasal nitric oxide (nNO) with asthma control and their value in the diagnosis of allergic rhinitis in children.@*METHODS@#A total of 186 children aged 5-12 years, who attended the outpatient service of the Department of Respiration, Shanghai Children's Hospital due to bronchial asthma and/or allergic rhinitis or who underwent physical examination, were enrolled as subjects, with 52 children in the asthma group, 60 children in the asthma+allergic rhinitis group, 36 children in the allergic rhinitis group, and 38 children in the control group. FeNO, nNO, and pulmonary function were compared between groups.@*RESULTS@#The asthma+allergic rhinitis, asthma, and allergic rhinitis groups had a significantly higher level of FeNO than the control group (P<0.05). The asthma+allergic rhinitis and allergic rhinitis groups had a significantly higher level of nNO than the asthma and control groups (P<0.05). The uncontrolled asthma and partially controlled asthma groups had significantly higher levels of FeNO and nNO than the completely controlled asthma group (P<0.05). The receiver operating characteristic (ROC) curve analysis showed that nNO had an area under the ROC curve of 0.91, with a sensitivity of 80.0% and a specificity of 89.5% in the diagnosis of allergic rhinitis in children with asthma (P<0.05).@*CONCLUSIONS@#The combined measurement of nNO and FeNO can be used to evaluate the control of asthma, and the measurement of nNO can help with the diagnosis of allergic rhinitis in children with bronchial asthma.

Research status of monoclonal antibody targeted therapy in children with severe bronchial asthma / 中国综合临床

Monoclonal antibody is a new treatment for severe asthma in children.It can selectively act on specific cytokines or pathways in the inflammatory cascade of asthma to block the inflammatory reaction, so as to reduce the number of acute attacks of asthma, reduce the dosage of drugs, and improve lung function.The main adverse reactions included injection site reaction and upper respiratory tract infection.At present, monoclonal antibodies for children include Omalizumab, Mepolizumab, Benralizumab, Reslizumab and Dupilumab.Although the efficacy of monoclonal antibody in children with asthma is obvious, its long-term effect and safety still need to be further confirmed by a large number of clinical studies.

Analysis of CHRM1 gene polymorphism with susceptibility to childhood asthma, pulmonary function and serum acetylcholine level / 国际儿科学杂志

Objective:To investigate the relationship between rs2075748 and rs542269 single nucleotide polymorphisms of cholinergic muscarinic receptor 1 (CHRM1)gene and susceptibility of childhood asthma, as well as the differences of pulmonary function and serum acetylcholine(Ach)levels among different genotypes.Methods:A total of 156 asthmatic children who were treated in the outpatient or hospitalized in the General Hospital of the Northern Theater Command from September 2018 to September 2020 were selected as the case group, while 134 non-asthmatic children who had a healthy physical examination were selected as the control group.The SNaPshot SNP typing technique was used to analyze the genotype of the CHRM1 gene rs2075748 and rs542269 of the study subjects.Serum Ach level was detected by double antibody sandwich method, and the pulmonary function of the case group was detected.Results:After analyzing the CHRM1 gene polymorphism, it was found that the CC, CT, and TT genotype frequencies at rs2075748 were 65.4%, 28.8%, 5.8% in the case group, and 62.8%, 32.4%, 4.8% in the control group.The C and T allele frequencies were 79.8% and 20.2% in the case group, 74.3% and 25.7% in the control group.There were no significant difference in the genotype and allele frequency distribution between the two group ( χ2=2.688, 2.530, both P>0.05), and there were no significant difference in the recessive and dominant modes between the two groups ( χ2=0.338, 2.686, both P>0.05). The TT and CT genotype frequencies at rs542269 locus were 72.4% and 27.6% in the case group, 62.7% and 37.3% in the control group.The T and C allele frequency were 86.2% and 13.8% in the case group, 81.3% and 18.7% in the control group.The genotype and allele frequency distribution were not obvious different between the two group ( χ2=3.145, 2.544, both P>0.05). The risk of asthma with variant CT and TT at rs2075748 locus of CHRM1 gene were not statistically different from that of wild-type CC (both P>0.05), and the risk of asthma with variant CT at rs542269 locus was no different from that of wild-type TT ( P>0.05). The difference in FEF50% Pred and FEF75% Pred of different genotypes at rs2075748 were statistically significant( F=3.118, 4.808, both P<0.05), wild-type CC was lower than variant CT(both P<0.05). There were no statistically significant difference in pulmonary function among different genotypes at rs542269 (both P>0.05). There was significant difference in serum Ach level between different genotypes of rs2075748 ( F=4.716, P<0.05), variant CT was lower than wild-type CC ( P<0.05), variant TT was lower than wild-type CC ( P<0.05), while no significant difference was find between variant CT and TT ( P>0.05). There was no significant difference in serum Ach level between different genotypes of rs542269 ( P>0.05). Conclusion:The rs2075748 locus of CHRM1 gene is not susceptible to asthma, but it may be related to the small airway function of asthmatic children, besides there are differences in serum Ach levels with different genotypes, and the variant serum Ach level is lower.The rs542269 locus is not a susceptibility site for asthma, and there are no difference in pulmonary function and serum Ach levels in asthmatic children with different genotypes.

Vitamina D y asma / Vitamin D and asthma

The main source of Vitamin D is the bioconversion of 7-dehydrocholesterol to cholecalciferol, however, the level of sun exposition has been drastically reduced during the last decades, so it is not unusual to find a high deficit of Vitamin D in the population. There is evidence to suggest that the deficit of Vitamin D is associated with a worse evolution of asthma and a greater risk of serious exacerbations. Possibly prenatal Vitamin D supplementation to pregnant mothers reduces the risk of wheezing and asthma in the offspring, and supplementation to asthmatic children could improve the evolution of the disease.

La principal fuente de Vitamina D es la bioconversión del 7-dehidrocolesterol a colecalciferol, sin embargo, el nivel de exposición solar se ha reducido drásticamente durante las últimas décadas, por lo que no es extraño encontrar un déficit elevado de Vitamina D en la población. Existe evidencia que sugiere que el déficit de Vitamina D se asocia a peor evolución del asma y mayor riesgo de exacerbaciones graves. Posiblemente la suplementación prenatal de Vitamina D a madres embarazadas reduzca el riesgo de sibilancias y asma en los hijos que nacerán, y la suplementación a niños asmáticos podría mejorar la evolución de la enfermedad.

Metabolomics Study of Exhaled Breath Condensate in Childhood Asthma by Gas Chromatography-Mass Spectrometry / 分析化学

Exhaled breath condensate (EBC) was analyzed by gas chromatography-mass spectrometry (GC-MS / MS) in childhood asthma and healthy control, aiming to find the potential markers of EBC in children with asthma, and provide a scientific reference for its pathogenesis and early screening. EBC samples were collected from 21 asthmatic children (age (8. 2 ±1. 6) years) and 17 healthy children ( age (8. 1 ±1. 3) years). GC-MS / MS was used to obtain the full scan data of chemical components. Cluster analysis was performed on the two groups of metabolites by principal component analysis (PCA), and potential biomarkers were found using Metaboanalyst 3. 0 attributable metabolic pathways. The results showed that the EBC metabolic maps of asthmatic group and normal group were very different, and eight endogenous potential biomarkers were identified, suggesting that starch and sucrose metabolism, lysine degradation, aminoglycan nucleoside metabolism, phenylalanine metabolism may play important roles in the development of asthma in children.

17q21 loci gene and childhood asthma / 国际儿科学杂志

Asthma,a chronic inflammatory airway disease,is influenced by both genetic and environmental factors.It is a complex disease that involves the interplay among multiple physiological processes.Currently,it has been identified that 17q21 loci genes especially orosomucoid like 3 (ORMDL3) and gasdermin B (GSMDB) are strongly linked with the susceptibility and severity of childhood asthma by using of the Genome-Wide Association Study (GWAS).Furthermore,a better understanding of the molecular mechanism contributes to the asthma target therapeutics and precision medicine.This review summarizes the 17q21 loci genes associated with the susceptibility,severity,and race specificities of childhood asthma.

Clinical Observation of Peiyuan Shengjin Tongqiao Decoction for Treatment of Childhood Asthma Complicated with Allergic Rhinitis / 广州中医药大学学报

Objective To investigate the effects of Peiyuan Shengjin Tongqiao Decoction, a Chinese herbal recipe with the actions of supplementing kidney to strengthen lung and dredging orifices , on traditional Chinese medicine (TCM) symptoms and lung function of childhood asthma complicated with allergic rhinitis. Methods Fifty-five childhood asthma complicated with allergic rhinitis were randomized into treatment group(N=28) and control group (N = 27). The two groups were treated with Budesonide and Formoterol Fumarate Powder for Inhalation, and the treatment group was given oral use of Peiyuan Shengjin Tongqiao Decoction additionally. After treatment, the clinical efficacy of the two groups was evaluated, and TCM symptom scores and lung function indexes [ the percentage of forced expiratory volume in the first second to the expected value (FEV1％) and the percentage of peak expiratory flow to the expected value (PEF％) ] were also observed before and after treatment. Results (1)After treatment for 3 months, the total effective rate of the treatment group was 92.86％, being superior to that of the control group (81.48％), and the difference was significant (P<0.01). (2) After treatment, the scores of cough plus asthma, rhinitis symptom scores and overall TCM symptom scores of the two groups were decreased (P < 0.01 compared with those before treatment) , and the rhinitis symptom scores and overall TCM symptom scores of the treatment group were lower than those of the control group (P < 0.01). (3) After treatment, PEF％ and FEV1％ were both improved in the two groups (P < 0.05 compared with those before treatment) , and the improvement in the treatment group was superior to that in the control group (P <0.05). Conclusion Peiyuan Shengjin Tongqiao Decoction is effective for the control of childhood asthmacomplicated with allergic rhinitis by improving rhinitis symptom scores, overall TCM symptom scores and lung function.

"""Treating winter diseases in summer"" acupoint application therapy for the treatment of asthma in children:a systematic review of randomized controlled trials" / 重庆医学

Objective To systematically evaluate the curative effect and safety of treating winter diseases in summer acupoint application therapy for asthma in children.Methods The domestic and international databases were retrieved till Feb 2017.The randomized controlled trials about treatment of treating winter diseases in summer acupoint application therapy for children with asthma were identified.The methodology quality of included trials was assessed.Results A total of 3 RCT involving 146 patients were included.The compositions of Chinese medicines and acupuncture points used were quite diverse,which inhibited us to conduct meta-analysis.The methodological quality of included RCT was generally lower.The results showed that treating winter diseases in summer acupoint application therapy might have advantage in reducing asthma acute attack times and improving clinical symptoms and respiratory function.Conclusion treating winter diseases in summer acupoint sticking therapy for asthma in children may have some advantages,however,due to the lack of a number of trials and poor methodology quality,the claimed benefits of treating winter diseases in summer acupoint sticking therapy for for children with asthma are inconclusive;more rigorous studies are warranted to support clinical practice.

Clinical application of childhood asthma control test / 中华实用儿科临床杂志

Objective To evaluate the childhood asthma control test(C-ACT) on the assessment of asthma by exploring the correlations among C-ACT,disease severity,the control level of pediatric asthma,disease partition and the changes in the pulmonary function as well as the score range,and to evaluate the feasibility and effectiveness of C-ACT's application to guide children's asthma control.Methods Two hundred and five children with asthma in the Pediatric Asthma Outpatient of Xiamen Hospital of Fujian University of Traditional Chinese Medicine from October 2011 to October 2015 were enrolled and randomly divided into control group and experimental group by random number table.The patients in the experimental group were monitored by the C-ACT with corresponding guidance,while patients in control group were treated without the monthly guidance of C-ACT after C-ACT involvement at the first time.C-ACT questionnaire score surveys were completed by all patients and their parents under the guidance of asthmatic specialists or nurses.Pulmonary function,disease severity and disease partition and the control level of pediatric asthma were detected and evaluated by doctors before and after treatment.The correlation between the results of C-ACT and the changes in the clinical indicators was assessed,and the improvement of lung function and the control rate of asthma were evaluated in 2 groups after 1 year.Results (1) There was no significant difference in gender,age and disease severity distribution based on the results of pulmonary function assessment between the control group and the experimental group (all P ＞ 0.05).(2) The C-ACT scores in normal,slight abnormal,moderately abnormal and severely abnormal pulmonary function were (24.79-± 2.20) scores,(21.67 ± 1.93) scores,(17.07-± 2.01) scores and (12.67 ± 1.81)scores,respectively,which showed the pulmonary function had a positive correlation with C-ACT scores (F =314.0,P ＜ 0.000 1).(3)Assessment of the reliability of C-ACT:the α value of Cronbach's coefficient for the scale was 0.867,which showed the high reliability.The correlation coefficients between the C-ACT score and the percentage of predicted value of forced expiratory volume in one second(FEV1％),the percentage of peak expiratory flow in the predicted value (PEF％) were 0.683 and 0.712,respectively,which also showed the strong reliability.(4) C-ACT scores in intermittent attacks of asthma,slight persistent asthma,moderate persistent asthma,severe persistent asthma were (24.47 ± 2.26) scores,(22.17 ± 1.86) scores,(17.42 ± 2.52) scores and (13.27 ± 2.11) scores,respectively,which showed the severity of asthma was positively associated with C-ACT scores (F =244.0,P ＜ 0.000 1).(5) C-ACT scores in controlled,partly controlled and uncontrolled asthma were (24.32 ± 2.34) scores,(18.87 ± 1.95)scores and (14.03 ± 1.32) scores,which showed the control levels of asthma had a positive association with C-ACT scores(F =394.0,P ＜ 0.000 1).(6)C-ACT scores in different disease partitions of green,yellow and red area were (24.72 ± 2.04) scores,(18.17 ± 2.03) scores and (15.06 ± 1.93) scores,which showed the diseases partition had an association with C-ACT scores (F =367.2,P ＜ 0.000 1).(7) After treatment of 3 months,6 months and 12 months,the control rates in the control group were 28.71％,67.33％,81.19％,but they were 44.23％,79.81％,95.19％ in the experimental group respectively.The control rates were higher in the experimental group than those in the control group,and the differences were significant (x2 =5.318,4.114,9.722,all P ＜ 0.05).Conclusion The C-ACT is highly correlated with pulmonary function,and our study show the C-ACT score range can help to make a quick assessment of disease severity,disease partition and the control level of children asthma.The application of C-ACT for the treatment of asthma has a good effect and it can be recommended and applied to childhood suitable for the promotion and application of children asthma clinics and community medical institutions at all levels of hospitals.

A randomized controlled study of vitamin D3 supplementation on childhood asthma control / 重庆医学

Objective To explore the effect of vitamin D3 supplementation on childhood asthma control for the purpose of providing a scientific basis for preventing the recurrence of childhood asthma.Methods A total of 92 children with asthma enrolled from January 2015 to December 2015 was divided into vitamin D group and placebo group by adopting double-blind randomized controlled design principles.Two groups were given a dose of 800 IU of vitamin D3 and placebo respectively,1 tablet per day for 2 months of treatment.The levels of asthma control and serum 25-hydroxy vitamin D3 and lung function index were examined at baseline,2 months and 6 months.Results A total of 83 patients completed the entire follow-up,including 43 patients in the vitamin D group and 40 patients in the placebo group.After 2 months,the level of asthma control in the vitamin D group was significantly higher than that in the placebo group(P=0.015) and the level of serum 25-hydroxy vitamin D3 was also higher in the vitamin D group than in the placebo group(P=0.042).There was no significant difference of pulmonary function index between the two groups(P＞0.05).After 6 months,the level of asthma control in the vitamin D group was still higher than that in the placebo group with no significant difference(P=0.094).There was no significant difference in the level of serum 25-hydroxy vitamin D3 between the two groups.The percentage of the less than 80％ peak expiratory flow rate(PEF％) was significantly decreased in the vitamin D group(P=0.029).Conclusion Short-term low-dose vitamin D supplement can enhance the level of asthma control and has positive clinical application value.

Association of LTC4S gene rs730012 single nucleotide polymorphism with childhood asthma / 国际儿科学杂志

Objective To investigate the association between the single nucleotide polymorphism (SNP) of leukotriene C4 synthase(LTC4S) rs730012 in the childhood asthma.Methods Sequence specific primers-polymerase chain reaction was used to assess the genetic polymorphism of LTC4S rs730012 in 105 asthma children with different order of severity and 128 non-asthma children in our hospital in the northeast of China to analyse the association between the SNP of LTC4S rs730012 and susceptibility,clinical phenotype in asthma children.Results (1) In case group,genotype frequencies of A/C,A/A and C/C were 71.4％ 、25.7％ 、2.9％,allele frequencies for A,C were 84.3％,15.7％.In control group,the genotype frequencies of A/A,A/C,C/C,were 70.3％,28.9％,0.8％,allele frequencies for A,C were 84.8％,15.2％.No significant difference was found in AA genotype and C allele frequencies between case and control grouP(x2 =0.035、0.020,P both ＞0.05).(2) C/C genotype or C allele frequencies in moderate-severe asthma group were significantly higher than the mild asthma group(x2 =5.859、5.641,P both ＜ 0.05);(3) SaO2 of A/A group was significantly higher than A/C and C/C group (t =2.976,Pboth ＜ 0.05),and FeNO and obstructive ventilatory disorder incidence rate in A/C,C/C group were higher than A/A group,the differences were statistically significant (t =2.946、x2 =5.564,P both ＜ 0.05).Conclusion The SNP of LTC4S rs730012 is associated with the order of severity,SaO2,FeNO,pulmonary function in asthma children of northeast China.However,the rs730012 is not associated with the susceptibility for asthma.

Clinical study of relationship between early neonatal respiratory faster and childhood asthma / 中国基层医药

Objective To explore the relationship between early neonatal respiratory faster and asthma in children in the future.Methods 82 cases of unexplained breathing faster after babies born were selected as observa-tion group,and 82 normal newborns at the same period were selected as the control group.The newborns were followed up for 4 -5 years,the incidence of neonatal asthma in the future were compared between the two groups.Results The indicators between observation group and control group had statistically significant differences (all P <0.05).In the observation group,there were 11 cases of clinical diagnosis of infantile asthma,the incidence rate was 13.41%(11 /82),and in the control group,there were 2 cases of clinical diagnosis of infantile asthma,the incidence rate was 2.44%(2 /82).The difference between two groups was statistically significant (χ2 =5.35,P <0.05).Conclusion Early neonatal respiratory faster is closely associated with asthma in children in the future.

Association between house dust mite (HDM) sensitisation and asthma control using skin prick test and HDM antigen specific IgE levels in saliva of Malaysian children

Background: Sensitisation to house dust mite (HDM) has been regarded as a major risk factor for development of asthma. This study was carried out to investigate the profiles of HDM sensitisation among Malaysian children with asthma. Material and Methods: The association between HDM sensitisation and control and severity of asthma was investigated. The salivary HDM specific IgE levels were quantified in different grades of control and severity of asthma in 125 unselected asthmatic children aged 5-12 years old attending the asthma follow-up clinic in Hospital Tuanku Ja’afar Seremban. An additional 29 non-asthmatic patients were selected as control. The skin prick test to assess sensitisation to Dermatophagoides pteronyssinus (DP) and Dermatophagoides farinae (DF) was performed on all the participants. A questionnaire regarding the control and severity of asthmatic symptoms of the subject was administered. Saliva was collected by voluntary spitting and ELISA was used to quantify the IgE specific to HDM antigen. Results: There was a significant association between sensitisation to DP and DF and the control of asthma. The association between DP sensitisation and severity of asthma just failed to reach a significant level although there is a clear trend for this. Significant association was found between DF sensitisation and severity. The HDM specific IgE in the saliva was significantly higher in asthmatic patients compared to non-asthmatic patients. There was no significant difference between the specific IgE levels in patients with different severity status of asthma. Conclusion: Salivary IgE levels may not be an appropriate indicator of the patients’ asthmatic condition in this study. However, it can be concluded that there is significant association between the sensitisation of HDM and the control and severity of asthma.

Prognostic factors for the outcome of childhood asthma in adolescence / 国际儿科学杂志

Asthma is the most common chronic respiratory disease in childhood,some children outgrow of the disease in adolescence.Understanding the outcome of childhood asthma is of increasing interest,the prognostic factors for the outcome of childhood asthma in adolescence are sex,onset age,the severity of disease,atopic status,airway responsiveness,lung function,living environment and so on.

Assessment of control of bronchial asthma in children using Childhood Asthma Control Test.

Background. The use of Childhood Asthma Control Test (C-ACT) has been advised for monitoring asthma control by the Global Initiative for Asthma (GINA) guidelines. Objective. To validate the tool C-ACT for the assessment of control of asthma and to examine the correlation between C-ACT score and lung function assessed by forced expiratory volume in one second (FEV1). Methods. This was a prospective observational study conducted between January 2010 to January 2011. Children diagnosed to have bronchial asthma and aged 5 to 14 years, were enrolled in the study. Asthma severity and control status were classified according to the National Asthma Education and Prevention Programme (NAEPP) and GINA guidelines, respectively. Patients were followed-up at three and six months and C-ACT and spirometric measurements were obtained. Results. Significant positive correlations were found between C-ACT score and FEV1 at enrollment (r=0.772) (p<0.001), three months (r=0.815) (p<0.001) and at six months follow-up (r=0.908) (p<0.001). Baseline C-ACT score was useful for predicting the levels of control of asthma upto three months (0.004), but not at six months follow-up (0.787). A cut-off C-ACT value of >19 had a sensitivity, specificity, positive predictive value, negative predictive value and area under the curve (AUC) 98.5%, 89.1%, 94.9%, 96.6%, 0.717, respectively for the control of asthma. Conclusion. C-ACT is a simple and feasible tool to assess and predict the levels of control in children with bronchial asthma upto three months.

Effects of Antibiotic Consumption on Children 2-8 Years of Age Developing Asthma / 한국역학회지

OBJECTIVES: Antibiotic exposure in children is a possible contributor to the increasing asthma prevalence in several countries. The present study aimed to investigate the association between antibiotic exposure and the risk of developing childhood asthma at 2-8 years of age. METHODS: A case-control study was undertaken among children aged 2-8 years old between March and September 2010 in the Urmia district in the northwest of Iran. The cases were doctor-diagnosed asthmatic children based on Global Initiative for Asthma criteria (n=207), and the controls were children without respiratory symptoms (n=400) selected by frequency matching by age and gender. Clinical data including antibiotic exposure was collected by a validated and reliable questionnaire, which was completed by interviewing parents/guardians. RESULTS: Antibiotic consumption during the first year of life increased the odds ratio [OR] of asthma symptoms at 2-8 years of age (crude OR, 2.26; 95% confidence interval [CI], 1.53-3.35; p<0.01), and the strength of association was similar after adjusting for a family history of asthma or atopic disorder, preterm delivery, birth order, and delivery method (adjusted OR, 1.91; 95% CI, 1.27-2.88; p=0.03). CONCLUSIONS: Our study suggests that antibiotic consumption in children was associated with an increased risk of childhood asthma, and an additional confirmative study is needed.

Risks on asthma among city children in China: a nationwide case-control study / 中华流行病学杂志

Objective A case control study was designed to explore the risk factors of asthma for city children residing for more than half a year,in China.Methods All physician-diagnosed asthma children enrolled in the 3rd nationwide survey (2010) in 43 typical cities of China were selected as the cases,and non-asthmatic children in the same survey were selected as control subjects if they wcre matched with the cases in age and sex.A revised questionnaire on the basis of ISAAC Phase Three Environmental Questionnaire was designed to investigate the risks of asthma among city children aged 0-14 years in China.Chi square analysis and generalized linear mixed models were performed to check the exposure difference between the cases and the controls.Results 43 out of the 44 city centers were qualified according to the results after reviewing both data from the survey and management.As a result,26 950 subjects including 12 450 asthmatic children and 14 500 control subjects were enrolled in the case-control study.Except for the children of Han ethnicity,another 5 980 children (22.2％) of ethnic minorities and 3 1 children (0.1 ％) born in foreign countries were also included as the study subjects.After controlling for city centers as random effect,age,sex,race,problems related to allergy,family history of asthma or allergy,personal medication history of antibiotics,preterm delivery,under caesarean section,baby age for introducing protein-contained foods,environmental tobacco smoking,maternal occupation,indoor plantings,room decorations,dampness,and cooking fuel were proved to be risk factors of childhood asthma.Some differences were seen in the risks of asthma between new cases and current cases.The risk for exposure to indoor plants was different between new cases (OR=2.09,95％CI:1.30-3.36) and current cases (OR=0.80,95％ CI:0.74-0.86).Risks on asthma were varied by age.Allergy,inflection,odor,and preterm delivery (OR=1.72,95％CI:1.42-2.08) appeared to be the key risks for asthma in children younger than 3 years.Apart from the risks,specifically for children younger than 3 years,the risks on asthma for children of 3 to 5 years would also include factors as:sex (OR=1.18,95％CI:1.03-1.35),low birth weight (OR=1.69,95％ CI:1.17-2.44),and caesarean section (OR=1.26,95％ CI:1.10-2.45).Apart from risks specifically for children younger than 6 years,age (OR=0.97,95％CI:0.95-0.99),race (OR=1.61,95％CI:1.26-2.06),and emigration (OR=1.68,95％CI:1.39-2.03) were proved to be associated with asthma for children aged 6-14 years.Conclusion Asthma risks for city children in China would include genetic factors,allergy,infection,and other environmental factors but called for further research in the country.